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目的 为探讨食管癌切除术后乳糜性胸水发生的病因、诊断和治疗手段。方法 对我院 1994年 4月～1999年 7月 480例食管癌切除术后 7例乳糜性胸水的临床资料进行回顾性分析。结果 乳糜性胸水发生率为 1.5 % ,多发生于中晚期食管中段癌的切除术后 ,尤其是术前放疗伴局部复发的食管癌。乳糜性胸水确诊后经保守治疗和再开胸行胸导管结扎术后均治愈。结论 对食管癌尤其是放疗后伴局部复发的食管癌切除术后早期发生乳糜性胸水、量持续超过 10 0 0ml/日者 ,尽早采用手术治疗。而对术后较晚发生乳糜性胸水、量低于 10 0 0ml/日的 ,可保守治疗 ,如果无效 ,再开胸行胸导管结扎术。
Objective To investigate the etiology, diagnosis and treatment of chylothorax after esophagectomy. Methods The clinical data of 480 patients with chylothorax after resection of esophageal cancer in our hospital from April 1994 to July 1999 were analyzed retrospectively. Results The incidence of chylothorax 1.5%, occurred in the middle and advanced esophageal cancer resection, especially preoperative radiotherapy with local recurrence of esophageal cancer. Chylothorax confirmed by conservative treatment and re-open thoracotomy after thoracic duct ligation were cured. Conclusion The incidence of chylothorax in patients with esophageal cancer, especial radiotherapy and local recurrence after esophageal cancer resection, lasts over 10 0ml / day, and the surgical treatment as soon as possible. Late onset of postoperative chylothorax, the amount of less than 10 0ml / day, conservative treatment, if invalid, then thoracotomy thoracic duct ligation.